Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria.
Institute of Outcomes Research, Centre for Medical Statistic, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
Int J Geriatr Psychiatry. 2021 Aug;36(8):1179-1187. doi: 10.1002/gps.5506. Epub 2021 Mar 8.
Evidence-based treatment of dementia includes pharmacological and non-pharmacological methods of which psycho-social interventions are an important component, commonly administered by occupational therapists. The aim of this study was to investigate the utilization of occupational therapy (OT) services and its association with survival in people taking dementia-specific medication in a population-based Austrian dataset compared to a two times as large control group without dementia-specific medication.
METHODS/DESIGN: A retrospective study with a 13-year observation period (2003-2016) was conducted on real-world data. Two stratifications were done and we used descriptive statistics, Chi-squared/Fisher's Exact Tests and survival analyses including three Cox models.
Data from 286,553 participants were analysed. Only 4.5% (n = 12,950) received OT services. In the dementia-medication group (n = 111,033), participants who received OT services (3.6%; n = 4032) had significantly more comorbidities (4.7%) compared to those without OT (3.5%; p < 0.001) and were also more likely to be male (4 vs. 3.5%; p < 0.001). While persons taking dementia-specific medication showed a slightly reduced survival with OT (p < 0.001) compared to those without, the result in the control group without dementia-specific medication showed a slightly better result of the participants who received OT (p < 0.001). The reduced survival in the dementia-medication group with OT is likely to be related to the higher number of comorbidities in this group.
People receiving dementia-specific medication were more likely to receive OT if they had additional comorbidities, however our analysis showed that utilization of OT services in Austria was very low indicating an overall insufficient accessibility of OT services for patients who needed it.
循证治疗痴呆症包括药物和非药物治疗方法，其中心理社会干预是一个重要组成部分，通常由职业治疗师进行。本研究旨在调查在基于人群的奥地利数据集与两倍于未接受特定于痴呆症药物治疗的对照组相比，接受特定于痴呆症药物治疗的人群中职业治疗（OT）服务的利用情况及其与生存的关系。
方法/设计：对 2003 年至 2016 年的真实世界数据进行了回顾性研究。进行了两次分层，并使用描述性统计、卡方/Fisher 精确检验和包括三个 Cox 模型的生存分析。
共分析了 286,553 名参与者的数据。仅 4.5%（n=12,950）接受了 OT 服务。在接受痴呆症药物治疗的组（n=111,033）中，接受 OT 服务的患者（3.6%；n=4032）的合并症明显更多（4.7%比无 OT 组的 3.5%；p<0.001），而且更可能是男性（4 比 3.5%；p<0.001）。虽然接受特定于痴呆症药物治疗的患者接受 OT 治疗后生存略有下降（p<0.001），但未接受特定于痴呆症药物治疗的对照组中接受 OT 治疗的患者的结果略有改善（p<0.001）。接受痴呆症药物治疗且接受 OT 治疗的患者生存下降可能与该组合并症较多有关。
如果有其他合并症，接受特定于痴呆症药物治疗的患者更有可能接受 OT，但我们的分析表明，奥地利的 OT 服务利用率非常低，表明需要 OT 服务的患者总体上无法获得 OT 服务。
